Apparatus, method, and system for pre-action therapy

ABSTRACT

Embodiments of the present disclosure provide an apparatus, method and system for physical, pre-action, extremity and related spinal cord, brain stem and neural therapies. An apparatus according to the present disclosure can include: a computing device configured to convert an input control action into a simulation instruction, wherein the input control action is provided by an input device; at least one simulated extremity operatively connected to the computing device and configured to simulate at least one modeled human anatomical movement based on the simulation instruction, wherein the at least one modeled human anatomical movement is distinct from the input control action; and a feedback device operatively connected to the computing device and configured to transmit a sensory response, wherein the sensory response is based on the modeled human anatomical movement.

RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/173,250, filed Oct. 29, 2018, which is a continuation of U.S. patentapplication Ser. No. 14/595,673, filed Jan. 13, 2015, both of which arehereby incorporated by reference, and which claims priority to U.S.Provisional Patent Application No. 61/926,551 filed Jan. 13, 2014, whichis hereby incorporated by reference.

BACKGROUND

The present invention relates to pre-action therapy for individuals whoare disabled, impaired or handicapped from making therapeutic physicalmovements. Pre-action therapy users engage in virtual anatomicalinteractivity to improve motor performance of body parts without theuser being required to perform actual, therapeutic physical movements.Particularly, the present invention is directed to pre-action therapy,synonymously virtual anatomical interactivity therapy and/or premotortherapy, for re-gaining motor control of body parts, e.g., upper and/orlower extremities due to acquired brain injury or other brain-motorcontrol disablement. The present invention includes systems, methods,program products and apparatuses for rehabilitation of paresis orparalysis. Further, the present invention includes particular types ofactivities such as feedforward and feedback directed toward userinput-controlled movements of virtual extremities, such as anatomicallyrealistic virtual extremities with analogous true range of motion, whichcan simulate human physical movements. The present invention furtherrelates to combinations of pre-action therapy coupled to therapeuticphysical activities.

SUMMARY

A first aspect of the present disclosure provides an apparatus forphysical, pre-action, extremity and related spinal cord, brain stem andneural therapies. The apparatus can include: a computing deviceconfigured to convert an input control action into a simulationinstruction, wherein the input control action is provided by an inputdevice; at least one simulated extremity operatively connected to thecomputing device and configured to simulate at least one modeled humananatomical movement based on the simulation instruction, wherein the atleast one modeled human anatomical movement is distinct from the inputcontrol action; and a feedback device operatively connected to thecomputing device and configured to transmit a sensory response, whereinthe sensory response is based on the modeled human anatomical movement.

A second aspect of the present disclosure provides a method forphysical, pre-action, extremity and related spinal cord, brain stem andneural therapies, the method comprising: translating an input controlaction into a simulation instruction for at least one modeled humananatomical movement, wherein the at least one modeled human anatomicalmovement is distinct from the input control action; simulating, with atleast one simulated extremity, the at least one modeled human anatomicalmovement based on the simulation instruction; calculating a differencebetween an ideal movement and the at least one modeled anatomicalmovement; and transmitting a sensory response to a user, wherein thesensory response is derived from the calculated difference.

A third aspect of the present disclosure provides a system for physical,pre-action, extremity and related spinal cord, brain stem and neuraltherapies. The system can include: an input device configured to receivean input control action from a user; at least one simulated extremityoperatively connected to the input device and configured to simulate atleast one modeled human anatomical movement based on the input controlaction; a feedback device operatively connected to the input device andconfigured to transmit a sensory response to the user; and a computingdevice operatively connected to the input device, the at least onesimulated extremity and the feedback device, wherein the computingdevice is configured to perform actions including: simulate, with the atleast one simulated extremity, the at least one modeled human anatomicalmovement based on the input control action, wherein the at least onemodeled human anatomical movement is distinct from the input controlaction, calculate a difference between an ideal movement and the modeledhuman anatomical movement and transmit a sensory response via thefeedback device to a user, wherein the sensory response is derived fromthe calculated difference.

BRIEF DESCRIPTION OF THE DRAWINGS

These and other features of this invention will be more readilyunderstood from the following detailed description of the variousaspects of the invention taken in conjunction with the accompanyingdrawings.

FIG. 1 depicts an illustrative system for pre-action therapysynonymously premotor, virtual anatomical interactivity and relatedphysical therapy, according to an embodiment of the present disclosure.

FIG. 2 depicts a component block diagram of a computer device accordingto embodiments of the present disclosure.

FIG. 3 depicts a component block diagram of an input device according toan embodiment of the present disclosure.

FIG. 4 depicts a process flow diagram illustrating a method according toan embodiment of the present disclosure.

FIG. 5 depicts a block diagram illustrating a machine in the exampleform of a computer system according to an embodiment of the presentdisclosure.

The drawings are merely schematic representations, not intended toportray specific parameters of the invention. The drawings are intendedto depict only typical embodiments of the invention and therefore shouldnot be considered as limiting the scope of the invention. In thedrawings, like reference numbering represents like elements.

DETAILED DESCRIPTION

Embodiments described herein relate to pre-action therapy (“P-AT”) usingmethods and apparatuses that provide for users' control of virtual humanbody parts (e.g., extremities). Further embodiments relate to thepresent invention in conjunction with demonstrated therapeutic physicalmovements and exercises such as those used in physical and occupationaltherapies. Embodiments of the present disclosure include activation ofat least one device attached or unattached to at least one human bodypart such that as the user controls the virtual body part(s), at leastone such device is simultaneously activated to stimulate one or more ofthe user's physical body parts, therefore combining physical andoccupational therapies with pre-action therapy. Additional embodimentspertain to the field of simulations for user pre-action therapy, i.e.,systems which provide for input to pre-action therapy separate from orin conjunction with physical action exercise and/or methods that providefor user control of virtual body parts.

Embodiments of the present disclosure include P-AT and interactive P-ATactivity (“iP-ATA”) related to physical and occupational therapy.Physical and occupational therapies in assisted or unassisted modesinclude control and manipulation of individuals' body parts(“extremities”) in order to regain, i.e., rehabilitate, purposefulphysical motor functions. Physical and occupational therapies aredirected, in part, to helping individuals solve their problem ofregaining or improving control of disabled, impaired or handicappedextremities. The problem addressed by P-AT/iP-ATA is individualsregaining or improving control of disabled, impaired or handicappedextremities without and before the individuals can move the extremities.The problem is exacerbated by hemiplegia, paraplegia, quadriplegia,paresis, other paralysis or injury affecting motor function of theextremities. The problem addressed by P-AT/iP-ATA is mis-addressedand/or under-addressed by virtual reality (“VR”) technologies that failto provide disabled, impaired or handicapped individuals with controlover virtual extremities. For example, motion capture by any of severaltechnologies (optical, magnetic, acoustic, etc.) can include the full orpartial movement of a human subject captured and recorded, typically bya computer system. The subject makes actual first person movements oractions. Resultant data points represent the actual body position ofjoints and/or limbs (or other components) in two-dimensional orthree-dimensional space, either statically as a snapshot or dynamicallyover time. Motion capture is irrelevant to individuals who cannot movetheir extremities.

Further and marginally relevant are goal-driven computer animationsystems containing a body model which receives target goals from asubject directing a first or third person pre-programmed action-to-goal.The goal driven system calculates, e.g., using inverse kinematics,necessary body positions and orientations for the animated body model toachieve. Goal driven systems conflict with P-AT/iP-ATA's user-drivenidiomatic control of virtual extremities which are anatomicallyrealistic with analogous true range of motion; i.e., the goal drivensystem provides the control, not the user. A goal driven system executesa virtual movement which completely bypasses the physical andoccupational therapy paradigm of an individual making a therapeuticphysical movement. Physical and occupational therapists advise, guide,or act to directly control patients' extremities. The present inventiondiscloses direct user control of virtual extremities by receivingspecific user inputs, i.e., pointing a cursor to virtual joints anddragging the associated extremity to a desired body position andorientation by non-corresponding (standard computer input, e.g., bymouse, keyboard, etc.) pre-action activities. In other words, the usercontrols virtual extremities and need not make (since she/he cannot movean extremity) a physical extremity movement in order for a simulatedphysical movement to occur. In P-AT/iP-ATA, virtual extremities can havemodel movements, but they are completely user controllable images ofbody parts programmed to simulate physical movements and actionsaccording to each user's custom, idiomatic control and direction. Assuch, P-AT/iP-ATA is consistent with and relevant to physical andoccupational therapies and individuals who are disabled, impaired orhandicapped from making therapeutic physical movements.

Embodiments of the present invention enable individuals, e.g., a user ora plurality of users, to use self-controlled and/or synonymouslyself-directed pre-action therapy simulations to stimulate brainstructures, cortices, synapses and processes. Operationally, a user cancontrol virtual body parts that are anatomically realistic withanalogous true ranges of motion to simulate physical movements andactions, thereby engaging in pre-action therapy simulations. Further,embodiments of the present disclosure include providing particular typesof feedback to the user based on distinct input controlled movementswhich may or may not correspond to a user's proficiency and/or thedisplaying of virtual body part movements.

Before or without being able to perform physical action(s), a user canuse input control using without limitation any input means, e.g., acomputer (hand or foot) mouse, keyboard, controller, touch-screen, heador eye actions, voice control, hand waving actions, measurement of brainsignals (e.g., electrical and/or measured neurological signals), etc.,whether transmitted by wired or wireless signals) that control/directsimulated physical movements and actions of on-screen or holographicimages or physical devices. A user's physical method of input can bephysically distinct from virtual physical aspects, appearance and/orversions of the simulated actions of on-screen or holographic images orphysical devices. As used herein, the term “simulate” and its relatedforms can refer to the display or demonstration of any action or groupof actions in which a model (virtual or physical) or image provided on,e.g., a display device, performs a particular movement, motion, action,animation, etc. In addition, a “simulated extremity” can refer to awholly virtual extremity, a physically simulated or modeled extremitysuch as a robotic extremity and/or combinations thereof. Simulatedactions can be at least partially manipulated or performed by a user.The user's inputs can control any virtual body parts, whether clothed,skin-covered, exposed, or simulated in any real or virtual environment.User inputs can control/direct or otherwise manipulate virtual bodyparts contemporaneously or simultaneously and/or activate at least onedevice attached or unattached to at least one human body part, such thatthe device activates or stimulates one or more of the user'scorresponding or non-corresponding actual (i.e., physical) body parts.

Physiologically, a user's disability, impairment or handicap challengemay be to initiate or improve physical or related neural actions beforeor without being able to perform or practice those actions. The presentinvention can be used for self or assisted therapy without limitation:to enable performing without limitation virtual and/or new actions orimproving past actions; for improving the user's ability to executevarious physical movements, actions, skills and techniques; forpotentiation of processes for replacement or supplementation of damagedneural circuits (e.g., help joint-replacement patients regainabilities); for de-activation of existing neuromuscular actions (e.g.,to decrease or stop users' uncontrolled muscle contractions); forde-sensitization of damaged neural circuits (e.g., actuating painfulbody parts); and/or for creation of synaptic processes to supplantdysfunctional and/or debilitating experiences (e.g., suffering fromphobias, schizophrenic hallucinations, autism spectrum disorder or othersensory-action disorder).

Existing theories hold that repeated stimulation of neurologicalreceptors may form “cell assemblies” and there are beneficialmathematical relationships between outcomes of repeated firing ofinterconnected neurological cells, synaptic formations and learnedbehavior physical movements. Embodiments of the present invention atleast include and provide for repeated, self-induced neurologicalstimulation and self-therapy, including neurological improvements bycombining particular types of feedback with particular types of userinputs.

Using an embodiment of the present invention, the user may controlsimulated physical movements and actions. Whether the user's attemptsucceeds, partially succeeds or fails, embodiments of the presentdisclosure can provide virtual and/or physical action-specific feedbackto the user based on her/his degree of success or failure, which may bedefined as a “proficiency” or “movement proficiency” or “actionproficiency.” Consequently, the user's processes for anticipatedintended and physical movements and/or actions and related processes areactivated. This activation may be followed by controlling and/ordirecting simulated actions. Using embodiments of the present invention,in which the user receives physical sensation feedback, may help toillustrate and reinforce what the user actually did. Repetition, byusing the present invention, in addition to feedback tracked to theuser's evolution in performance, can improve the user's abilities andcan reinforce the user's self-therapy by repeating positive physicalsensation feedback and/or reducing and eliminating negative physicalsensation feedback.

Epidemiologically and by way of example, the combined, annual incidenceof ABI, stroke and TBI alone, in the United States affects about 2.5million survivors annually. A broader category, neurotrauma (penetratingand non-penetrating), including primary brain tumor, focal dystonias,limb apraxia/ataxia, cerebral palsy and amputations, annually affectsmore than 12 million U.S. civilians and approximately 200,000-400,000combat veterans. Assuming that the incidence of ABI/TBI alone isgenerally uniform worldwide, by extrapolation the total number ofABI/TBI survivors worldwide would therefore exceed 275 millionindividuals, which represents a number approximating the entire U.S.population. The total number of spinal cord injury survivors in theUnited States is approximately 200,000-250,000 and over 3,000,000worldwide.

Purposeful and reflexive physical actions of body parts are proximallyderived from neuronal signaling (spinal cord outputs) to muscles.However, pre-action therapy for purposeful actions is derived fromneuronal signaling (outputs) of brain structures or processes initiatingneuronal signaling to the spinal cord. Brain communications allow usersto initiate purposeful new physical actions or to regain the ability toperform said physical actions or to correct physical, neurological orpsychological actions associated with disorders or conditions.

The damaged brain, no less than other damaged body parts, requirestherapy or rehabilitation. P-AT/iP-ATA stimulate brain-motor-controlactivity. No known virtual anatomical interactive technologies otherthan those disclosed in this disclosure are directed to pre-actiontherapy in virtual environments. An example implementation of thesystems and methods described herein can apply to persons suffering frombrain-motor-control and sensory-related diseases and/or injuries.Acquired brain injury (“ABI”), including stroke, chronic traumaticencephalopathy, spinal cord injury and traumatic brain injury (“TBI”),survivors or without limitation individuals affected by any disabling,damaged or dysfunctional condition, disorder, or experience may sustainimpaired or eliminated use of one or more body parts. The result isformation of mild to severe barriers to physically controlling one'smovements, actions and environment. The barriers exist despite, in manyinstances, body parts being completely or partially physicallyuninjured. For ABI survivors it is fair to say that except for the braininjury (and consequential extremity atrophy) chronic physical actiondeficits in the extremities would not require rehabilitation. To addresssaid deficits, ABI survivors undergo long-term and costly therapeuticand rehabilitative procedures. These are major healthcare servicesand/or cost problems.

Conventional rehabilitation/therapies for treating ABIs are primarilyphysical movement in nature involving assisted and independent effortsto restore survivors to being able to make unaffected physical movementsand actions. Physical and occupational therapy actions are characterizedin that the movements of survivors' body parts correspond to unaffected,therefore rehabilitative movements. For example, when a survivorrecovering from a stroke or TBI undergoes rehabilitation to regainproper axial movement of the survivor's arm at the shoulder, thesurvivor with or without assistance repeatedly attempts to move (or havemoved with professional or mechanical assistance) her/his arm in theaxial direction. Those movements are to promote recovery according toconventional therapy or rehabilitation emphasizing correspondingmovements. In contrast, the present invention's methods, systems andapparatuses for pre-action therapy principally target brain structures,cortices, synapses and processes i.e., principal pathological sites forABI/TBI survivors or other affected individuals, without requiring thesurvivor's corresponding movements.

Making corresponding physical therapy movements are variably effective,but difficult or impossible for those recovering from paretic, paralyzedand/or hemiplegic ABI/TBI or other conditions or disorders noted in thisdisclosure. From survivors' perspectives, the challenges and questionsare how to regain physical actions or to move without (and before) beingable to move. ABI/TBI survivors are left with disconnections between, onone hand, intact and in many cases, initially physically uninjured bodyparts and on the other hand, dysfunctional brain activity required formovements of body parts. In some cases, a survivor's difficulties aremagnified due to the survivor's non-awareness of the existence of anunusable, disabled, impaired or handicapped body part. One challenge forABI/TBI survivors is to regain the use of body parts. A technicalchallenge addressed with embodiments of the present invention is forusers to control virtual body parts to make simulated movements andactions before, during, after or adjunctive to using physical orassistive rehabilitation or therapeutic methods that use correspondingphysical actions made by such body parts. Thus, to regain full andexpeditious control of using ABI/TBI-affected body parts, the presentmethods and apparatuses provide pre-action therapy.

Conventionally for ABI, at least one of three non-virtual-anatomicaltherapies can be used. These include, motor imagery; mirror therapy; andaction-observation therapy. Motor imagery involves imagining motorcontrols and attempting to physically exercise the resulting imagery.Mirror therapy has been used for amputees experiencing phantom limbpain. It involves using an intact body part to make physical actionsreflected in a physical mirror. The mirrored actions appear to be madeby the contralateral (amputated) body part. The patient's observation ofsaid actions has been shown to decrease or terminate phantom limb pain.Action-observation therapy is theoretically mirror neuron based andinvolves viewing physical actions followed by the patient's efforts toimitate the observed actions. Embodiments of the present invention,unlike other therapies or rehabilitation techniques, enables individualsto make, in a virtual environment, independent inputs that interactivelycontrol virtual body parts and activate attached or unattached body partdevices such that the devices activate or stimulate one or more bodyparts to make an actual physical movement. By personally causingsimulated physical actions to be simulated and thereby actual physicalmovements/actions to be made, users produce real visuomotor (i.e.,visuo-action) feedback from said simulated movements/actions and inducerehabilitation.

Humans excel in physical action, the result of making repeated physicalactions, accompanied by feedback from such actions, resulting inimproved motor actions. For unaffected individuals, the process ofcreating productive sensorimotor feedback derives from making actualphysical actions in the real world. That process is variably unavailableor impossible for many survivors of ABI and/or the presently disclosedconditions. However, for ABI survivors the present invention may be usedto create productive virtual action feedback directed to regainingand/or improving physical actions for daily living without making actualphysical actions in the real world.

Aspects of the present invention relate to methods and apparatuses forpre-action therapy, also disclosed as pre-action therapy for ABI/TBIsurvivors. The term ABI/TBI survivors in the present disclosure includeswithout limitation other conditions and disorders presently disclosedand others to which pre-action therapy may be useful. More particularly,the present invention is for pre-action therapy by ABI/TBI survivors andother individuals using virtual body parts. In an aspect, a user, whomay be an ABI/TBI survivor, may engage in one or more interactivepre-action activities. iP-ATA provides ABI/TBI survivors withalternative physical-action feedback. iP-ATA feedback fosters the user'srestoration of pre-action motor control processing viacontrolled/directed, virtual body parts corresponding to at least theuser's body parts that suffered reduced or lost functionality as theresult of ABI or TBI. Such survivor controlled/directed, virtual bodyparts are caused by the user to simulate physical movements and actionsthereby executing virtual-world activities as pre-action therapy forreal world activities. In an additional aspect, P-AT and iP-ATA providethe ABI/TBI survivor with a pre-action therapy workout that stimulates,e.g., neuronal recruitment, inter-neuron communication synaptogenesisand brain plasticity.

P-AT/iP-ATA provides a method, apparatus and platform with which to linkuser-controlled virtual extremities to user-originated simulatedphysical movements. An iP-ATA can include exercises used in pre-actioncontrol/direction of virtual body parts to simulate physical movements.

According to aspects of the present disclosure, interaction with virtualbody parts links the user to virtual action feedback. Furthermore, themethods and apparatuses and platform described in the present disclosurecan engage ABI/TBI survivors in self-therapy for purposeful physicalactions.

According to aspects of the present disclosure, an ABI/TBI survivor maytarget and help overcome her/his action deficits by making inputcontrols to a system that simulates a user-controllable virtual bodypart, thereby directing and causing simulated actions of a movableregion of the virtual body part based on the inputs, viewing feedbackfrom such simulated actions and building new and/or rebuildingeradicated, diminished and/or impaired neurological processes.

According to the present disclosure, a user may control and directvirtual body part(s) to display simulated, human physical actions with avirtual full range of motion. The user may control a virtual body partto speed up, slow down, stop or make any combination of said actions orgradations of the same. P-AT/iP-ATA displays of virtual body partactions may be idiomatic representations of each survivor's inputcontrols and direction. In effect, the user's virtual body part controlprocess provides neurological stimulation for real physical movement andaction processes.

In an aspect, a computer device may control the display and virtualmovement of the virtual body part and may transmit one or more signalsto a physical body part device, which may stimulate one or more bodyparts of the user to move, for example, in a way that may correspond tothe movement of the user-directed virtual body part. In some examples,the physical body part device may cause body part movements bystimulating one or more receptors or triggers of the user's neurologicalsystem, which may in turn cause movement of the muscles, tendons,tissue, or any other portion of the user's body.

Furthermore, the methods and apparatuses presented herein differ frommodern therapy systems, e.g., Nintendo Wii™ and Microsoft Kinect™, whenimplemented for physical and occupational rehabilitation and relatedprocesses. Wii™ and Kinect™ systems require users to make actualphysical movements and actions that are then simulated, e.g., in virtualenvironments. By design and practice, Wii™ and Kinect™ users performactual physical movements and actions that correspond to simulatedactions. Conversely, the methods and apparatuses presented hereineliminate the requirement of user performance of corresponding physicalactions to what are then displayed as simulated physical actions. Forexample, a user can make small or limited non-corresponding eye and/orhead gestures carried by webcam signals and by wired or wirelesstransmitted brain signals, to control the simulated movements andactions of virtual body parts. In one example, any user's input signalsby eye controls (alone) can direct a virtual shoulder to move an arm 90degrees away from the body. Accordingly, a user's input controlsassociated with embodiments of the present invention may benon-corresponding, that is to say a user's physical method of input,e.g., eye, mouse or by wired or wireless transmitted brain signals, doesnot correspond to the simulated movements and actions of the virtualbody parts of the present disclosure.

The inputs (controls and directions from users) described in the presentdisclosure may be dissociated from displayed virtual-image actions andallow ABI/TBI survivors to cause simulated physical movements andactions before and without performing real physical therapy. Each user'sinput according to the present disclosure may not be physical-therapyaction movements of the desired movement or action. Rather, the presentmethods and apparatuses target without limitation neuronal systems,neural structures, gray and white matter circuitry, neurogenesis,synaptogenesis, myelination, brain plasticity and related neuralprocesses, not necessarily any particular physical-action.

Physical therapy participation, due to its repetitive aspects, can betedious and hindered by boredom. Participation in physical therapy isalso fraught with a new injury or aggravating an old injury. P-AT/iP-ATAprovide entertaining, rewarding and immersive features, including actionsequence actions that result from a user's successful control, directionand manipulation of virtual body parts and objects or non-virtualrobots, prostheses or exoskeleton body parts.

For example, in terms of non-limiting and non-exclusive variations ofpractical application, as well as research and investigation, monitoringbrain activity can enhance pre-action therapy value. By using standard,readily available equipment, ABI/TBI survivors' brain activities orprocesses can be measured through any brain imaging technology or byanalyzing blood and/or other body fluids, or biomarkers, or othersubstances for particular bio-chemicals, markers and/or compoundsrelated to without limitation overall neural activity. ABI/TBIsurvivors' baseline neural activities or processes could be determinedbefore, during and after pre-action therapy to measure changesaccompanying pre-action therapy. Additionally, ABI/TBI survivors' brainactivities or processes can be compared to non-ABI/TBI affectedindividuals undergoing or who underwent pre-action therapy activities todetermine whether pre-action therapy is stimulating the same or similaraffected parts of the ABI/TBI survivors' brains as are stimulated in thenon-ABI/TBI affected individuals' brains. An iP-ATA program can beadjusted accordingly to enhance the neural activity or processes in theidentified neural structures, processes or circuitry of the ABI/TBIsurvivors to match brain activities (including substance quantities,levels and the like) of non-affected individuals' brain structures,processes or circuitry accompanying iP-ATA. Other non-limiting andnon-exclusive variations on the process, e.g., providing haptic feedbackand other types of sensory feedback to a user during a P-AT-basedsession, are discussed in the present disclosure.

P-AT/iP-ATA can also be used as diagnostic tools. Some ABI/TBI survivorssuffer mild brain injury and current diagnostics are limited to mostlysubjective tests combined with some technical means. Additionally, whilemoderate to severe ABI/TBI is detectable through changes in brainmorphology by CT-scans, MRI or other imaging technologies, mild ABI/TBIis difficult to detect or diagnose. Any survivor, who does not showsevere or moderate ABI/TBI, could be introduced to iP-ATA to monitor formild ABI/TBI. Mildly affected patients would engage iP-ATA and her/hisbrain activities would be compared to unaffected individuals' baselinebrain activities to determine the comparative state or extent of mildinjury or the possibility of unlikely or undetectable injury. P-AT maybe used for assessing other levels of ABI/TBI, either solo or inconjunction with other methods or devices.

Various aspects are now described with reference to the drawings. In thefollowing description, for purposes of explanation, numerous specificdetails are set forth in order to provide a thorough understanding ofone or more aspects. It may be evident however, that such aspect(s) maybe practiced without these specific details. Turning to FIG. 1, a system100 for presentation and manipulation of a virtual body part as a meansfor pre-action therapy by a user is shown. In an aspect, system 100 mayinclude a computing device 102, an input device 104, a display device106 and a user measurement device 108. As used herein, the term “displaydevice” can include any instrument for providing a physical or virtualview or demonstration of a simulation, image or model and withoutlimitation can include display devices (e.g., monitors, televisions,touch screens, etc.), robots, machine models and/or other physical orvirtual representations. Additionally, system 100 may include a bodypart device 128 and/or a feedback device 130. According to an aspect,computing device 102 may include, e.g., a digital computing deviceconfigured to receive and process one or more user inputs 110 from inputdevice 104, one or more user characteristics 112 from user measurementdevice 108, and may generate and transmit one or more displayed imagesand control messages 114 to display device 106. In addition, computingdevice 102 may be configured to execute manipulation of a simulatedvirtual body part based on at least the inputs of user 120.

Furthermore, computing device 102 may include a processing engine 116,which may be configured to receive, process and transmit signalsassociated with the simulation, control and/or behavior of a virtualbody part. The movement of the virtual body part is effected by themovement manager 126. Additionally, computing device 102 may include amemory 118, which may be configured to store user characteristics (suchas neurological or chemical characteristic values observed and/ormeasured from a user 120) and/or instructions for executing one or moreiP-ATA.

System 100 can simulate action and pre-action therapy based on movementsof a first demonstrative virtual object image on display device 106 andat least one input device 104 for providing an input to system 100 tocontrolling at least one additional user-controllable virtual objectimage or virtual body part. In an example, display device 106 of system100 can simulate the demonstrative virtual object or body part making anexemplary movement, task or skill associated with the demonstrativevirtual object. The user may then, without limitation, use a physical,virtually representative or brain signaling device (e.g., in the form ofinput device 104) that may (or may not) correspond to the demonstrativevirtual object in physical composition to emulate/mimic or oppose theexemplary movement, task or skill of the first demonstrative virtualobject image on display device 106.

Furthermore, display device 106 may be configured to simulate one ormore virtual body parts and actions of the simulated virtual bodypart(s). In an aspect, display device 106 may simulate a virtual bodypart visually on a screen or display, such as, but not limited to, acomputer monitor, projector, television, or the like). The virtual bodypart(s) on display device 106 can be affected and/or controlled by userinputs from input device 104, and thus may be a “user controllable”virtual body part. Virtual body part(s) on display device 106 may carryout simulated human anatomical movements which represent a simulated,physically achievable anatomical movement and/or action in response tosignals encoded in inputs 110. Further, the movements, actions,animations, etc. performed with the virtual body part(s) on displaydevice 106 can be distinct from the physical aspects of actionsperformed by user 120 to generate inputs 110 with input device 104.

Display device 106, in addition to displaying model anduser-controllable virtual body parts, can display other informationrelated to physical and neural therapy. As user 120 manipulates virtualbody parts through input device 104, display device 106 cansimultaneously or alternatively display statistics related to theperformance of user 120. For example, computing device 102 can calculatestatistics related to a user's proficiency in one or more iP-AT/IP-ATAAsand display these statistics on display device 106. In embodiments wheremore than one user 120 interacts with system 100, statistics for eachuser can be calculated and compared by computing device 102 and shownwith display device 106. In addition, display device 106 can allow user120 to view video (e.g., previous emulation, mimicking of particularmovements and gestures) to observe correct and/or incorrect movements ascontrolled by user 120 through input device 104. In some examples,computing device 102 can generate a video representation of a previousinput controlled movement, shown on display device 106 in a “play” or“playback” mode. The video generated with computing device 102 can bedisplayed in a first-person perspective, a third-person perspective, orany other playback perspective currently known or later developed. Inaddition, user 120 can view video of system 100 being operated byanother user (not shown) of system 100, either previously orsimultaneously. In a further addition (also not shown) displayed videomay be accompanied by audio and/or closed captioned; just as recorded orgenerated audio can be presented with, without or instead ofaccompanying video and/or displayed messages.

In an aspect, input device 104 may be configured to receive one or morephysical or non-physical inputs 122 from user 120 to translate, processand forward the translated and/or processed inputs to computing device102 as inputs 110. Although a single user 120 is shown by way of examplein FIG. 1, it is understood that an input device or a plurality of inputdevices 104 can receive physical or non-physical inputs 122 from a useror a plurality of users 120 for each system or a plurality of systems100. Thus, computing device 102 can receive cooperative and/or competingphysical and/or non-physical inputs 122 from simultaneous and/orsequential, cooperative and/or competing users 120, and display singleor multiple simulated human anatomical movements of single or multiplevirtual body parts. In an aspect, input device 104 may be any means ofreceiving direct physical or non-physical input from a user 120, suchas, but not limited to a keyboard, mouse, touch pad, smart phone,laptop, computer, motion control system, gesture sensor, brain computerinterface, etc., which may or may not include a representation of aphysical tool, instrument, etc., a sensory body harness, or genericcomputing device, an input device that senses input without interventionof the user, etc. In addition, it is understood that user 120 canrepresent several users, each participating in a competitive,cooperative, simultaneous and/or sequential fashion. Thus, embodimentsof the present disclosure contemplate multiple users each engaging intherapy with a single computing device 102 or with multiple computingdevices 102.

Alternatively or additionally, input device 104 may be a deviceconfigured to generate input 110 by recognizing and processing one ormore user actions via user action recognizing component 124. Forexample, in an aspect, user action recognizing component 124 may beconfigured to recognize user inputs via, e.g., non-limiting example, eyeaction, nominal physical action of hands or other body parts, blinking,nodding, vocal control and/or by detecting and monitoring neurologicalsignals generated by the user's body. For example, user actionrecognizing component 124 may include a component capable of readinginstructions signaled in the brain, spinal cord, or any otherneurological circuit or tissue of user 120. In an embodiment, useraction recognizing component 124 of input device 104 can include anelectroencephalography (“EEG”) device or a similar device that reads andinterprets brain signals generated by the user and transmits brainsignals to system 102. Furthermore, the signals from any form of inputdevice 104 (including, without limitation, said EEG device) may betransmitted as input 110 to computing device 102 via any means oftransmission, including Bluetooth™ wireless data exchange methods orother wireless or wired communication methods or standards.

Alternatively or additionally, a body part device 128 may receive one ormore external body part control signals 132, which may cause body partdevice 128 to move, for example, by mechanical means. In an aspect, bodypart device 128 may be, but is not limited to being, a robotic arm,shoulder, or the like. In some examples, the body part device 128 maystand alone and be placed in a location viewable by user 120.Additionally, the external body part device may be attached to user 120,which may allow the user to witness real-time or substantially “true tolife” actions associated with his or her physical inputs 122.

In an additional or alternative aspect, body part device 128 may beconfigured to receive one or more control signals from computing device102 corresponding to the virtual movement of the virtual body part beingmanipulated by the user. Based on the one or more control signals, thebody part device 128 may process the control signals and stimulate oneor more target body parts 150 of user 120 (or of a non-user (not shown))to prompt movement of one or more body parts, which may include targetbody part 150.

In yet another aspect, system 100 may include a feedback device 130configured to provide feedforward and/or feedback (collectively,“sensory response 136”) to user 120 (and/or intervening devices inalternative embodiments), which optionally can be provided directly totarget body part 150 along the corresponding phantom line in FIG. 1. Inan aspect, feedback device 130 may receive one or more feedback controlmessages 134 related to the feedback device from computing device 102,which may govern the action and behavior of the feedback device 130. Inan aspect, feedback device 130 may be configured to generate, bynon-limiting example, force feedback, pneumatic feedback, auditory orvisual feedback, non-force feedback, or any other form of feedforwardand/or feedback that may indicate an output of computing device 102related to pre-action therapy. For example, feedback device 130 mayinclude a sensory response unit 138, which can be in the form of, e.g.,a mechanical device that a user may attach to his or her hand or armthat may provide force feedback to the user's hand or arm in order tobend the user's wrist. In such an example, this bending may occur wherethe user selects a virtual wrist on display device 106 and moves thevirtual wrist up and down (or in any direction) by moving input device104. Based on this input, processing engine 116 may generate andtransmit a feedback control message 134 to feedback device 130 which mayprovide a force to the user's body part (e.g., a wrist) to move the bodypart substantially in unison with the action of the virtual image, whichmay or may not be shown on display device 106 concurrently.

Further, the present disclosure contemplates a variety of methods anddevices for providing feedback from feedback device 130, allowing usersto learn and practice an exemplary movement, task or skill based ondisplayed demonstrative actions, including physically achievablesimulated human anatomical movements, with one or more virtual bodyparts. Output from feedback device 130 may include haptic feedback, alsoknown in the art as “tactile feedback,” or may also include other typesof feedback (e.g., auditory feedback). Haptic feedback may includefeedback to a device that is secured to, held by, or manipulated by auser to provide actual forced movement of target body part 150 (e.g., anelectrically actuated, computer controlled harness, arm strap, etc.,that may force the hand and/or arm to extend or retract at the elbow) orsensory/tactile feedback (e.g., a user's mouse or trowel or otherphysical object that e.g., can vibrate, pulse and/or provide varyingtemperature sensations to user 120). Computing device 102 can controlthe feedback provided with feedback device 130 to excite neurons in aprefrontal cortex, premotor cortex, supplementary motor area, etc. ofuser 120. As discussed elsewhere herein, premotor action planning byuser 120 can be affected by visual and tactile stimulation. Thus,sensory feedback provided with feedback device 130 can be customized tomentally stimulate user 120 in different ways to accommodate varyingneeds and situations. Computing device 102 can also control the extentof sensory feedback provided by feedback device 130 through programcode. The degree of sensory feedback sensations provided to user 120 canbe derived by computing device 102 by comparing input controlledmovement 110 against a “model movement,” which can represent a modelsimulated human anatomical movement. The model simulated humananatomical movement can be stored on computing device 102 (e.g., inmemory 118) or on an external computing device or processing system.Thus, user 120 can receive feedback through feedback device 130 whichindicates his or her degree of success in imitating or opposing themodel simulated human anatomical movement.

Aspects of system 100 according to the present disclosure can include ademonstrative virtual object image, e.g., a virtual body part, beingdisplayed on display device 106. The demonstrative virtual object imagecan demonstrate a model simulated human anatomical movement, or othersimulated action or gesture, before, during, or after the time that user120 provides physical or non-physical inputs 122 to input device 104.Computing device 102 can define feedback control messages 134 based onthe accuracy or correctness of input controlled movements as compared tothe model simulated human anatomical movement, action, or gestureperformed with the demonstrative virtual object image.

In an embodiment, input device 104 and feedback device 130 can be partof a user interface device 160 (shown in phantom). User interface device160 can integrate input and feedback aspects of system 100 to centralizethe physical and neural therapy experience of user 120. In anembodiment, user interface device 160 can include a computer mouse withsensory response units 138 installed therein. Thus, user interfacedevice 160 can enhance the therapy of user 120 by providing immediatefeedback, as user interface device 160 can be a single component forinteracting with computing device 102 to communicate inputs 110 andreceive feedback control messages 134.

User interface device 160, including input device 104 and feedbackdevice 130, can take many other forms. For example, input device 104 mayinclude a motion-based controller system similar to those found in theNintendo Wii™ or Microsoft Kinect™. In addition or alternatively, abiomedical sensor glove, e.g., a glove device according to theArmAssist™ system developed at McGill University, Canada, can be usedfor input device 104, body part device 128 and/or feedback device 130.In other example embodiments, input device 104, feedback device 130and/or user interface device 160 can include, e.g., a real orrepresentative: baseball glove or bat or hockey stick with vibrationcapability; a trowel with force-feedback or vibration capability; or anyother object used in any trade or profession (e.g., without limitation,a scalpel for surgery, pen, pencil or brush for drawing, a diamondcutting tool) or sport movements involving pre-action and action therapyor the like. Further, input device 104 can be configured to detect auser's brain signal (e.g., an electrical or neurological signal), andprovide input 110 based on detecting the user's brain signal. Forexample, input device 104 may be any currently known or later developeddevice configured to identify whether a particular brain activity ofuser 120 occurs, and transmit input 110 to computing device 102 based onidentifying that the particular brain activity is occurring in thepresent, or has previously occurred. Other embodiments of the presentdisclosure can include an industrial therapy system (e.g., metalworkingor welding) or skill therapy system (e.g., culinary therapy) whichallows user 120 to engage in pre-action therapy with an embodiment ofsystem 100 before being introduced to traditional physical andoccupational therapy methods that may be more expensive, dangerous, orerror prone.

In an additional aspect, system 100 may include a user measurementdevice 108, which may be configured to measure one or more usercharacteristic values before, during, and/or after engaging inpre-action therapy activities. In some examples, user characteristicvalues may include without limitation neurological or chemical data,pulse, blood pressure, or any other measurable characteristic orphysical parameter of an animal, which may include a human being. In anaspect, user measurement device may use imaging technology to measurethese user characteristics, and such imaging technologies may include,without limitation, Magnetic Resonance Imaging (“MRI”), FunctionalMagnetic Resonance Imaging (“fMRI”), Computed Tomography (“CT”),Positron Emission Tomography (“PET”), Electroencephalography (“EEG”),Magnetoencephalography (“MEG”), Multi-Voxel Pattern Analysis (“MVPA”),Near-InfraRed Spectroscopy (“NIRS”), and High Density Fiber Tracking(“HDFT”). Thus, user measurement device 108 can include a component orgroup of components which function as a neuronal activity monitoringdevice in communication with computing device 102, which can allowcomputing device 102 to monitor the neuronal and/or brain activity ofuser 120. Activity sensed with user measurement device 108 can affectthe display or demonstration of simulated body parts, movements, etc.,by computing device 102 in an iP-ATA. In particular, program code for agiven iP-ATA may include commands to adjust the display of actions,gestures, movements, etc., to improve the proficiency and accuracy ofuser 120. In some embodiments, settings adjustments within a particulariP-ATA may occur in real time based on continuous input from user 120simultaneously with the operation of input device 104 and feedbackdevice 130.

In a further aspect, user measurement device 108 may send the measureduser characteristic data 112 to computing device 102 upon measurement.The user characteristic data may be stored in memory 118 for later useor fed to processing engine 116 as feedback data that processing engine116 may use to alter an ongoing pre-action therapy activity, such as anongoing iP-ATA, or may be used to diagnose a medical condition.Alternatively, where the user characteristic data is stored in memory118, such data may be used to tailor future iP-ATA to the user'sindividual characteristics and/or current skill level and/or to trackthe progress of a user over time and/or to improve P-AT/iP-ATA.

Another aspect of system 100 can include a computer-controlled restrainttherapy device 152 (alternatively identified as a “restraining device”)optionally mechanically coupled between feedback device 130 and user 120and/or target body part 150. Restraint therapy device 152 can forceparticular body parts, extremities, etc., of user 120 (and/or targetbody part 150, as shown by the corresponding phantom line in FIG. 1) toremain in place during physical and/or neural therapy to improve thefeedback and therapy of particular body parts. Restraint therapy device152 can be in the form of single or multiple restraint therapy devices152, which can be added and removed as desired to customize the therapyof user 120. In an embodiment, restraint therapy device 152 can includeone or more devices configured to restrain up to and including allbodily extremities of user 120. As an example, where user 120 may desiretherapy in only one arm, computing device 102, optionally throughfeedback device 130, can dispatch a signal 154 (shown in phantom) torestrain at least one extremity of user 120. The restrained extremitycan be the extremity to be trained (e.g., to mandate particular types ofmotion), or an extremity which is not trained (e.g., to prevent otherbody parts from moving).

Turning to FIG. 2, an illustration of components comprising computingdevice 102 (FIG. 1) is provided. In operation, computing device 102 maypresent an initial or default virtual body part to a user, for example,when the user, therapist, or any other type of user initially boots upcomputing device 102, selects an iP-ATA. To display this default virtualbody part, virtual body part manager 204 may query memory 118 fordefault parameters 224 of a set of physical characteristic values 220stored thereon and may process and display the default virtual body partby sending, for example, one or more display images and messages to adisplay device 106. In addition, once the user begins a P-AT session,computing device 102 may receive inputs from the user, such as, but notlimited to, selection inputs and action inputs. Based on these one ormore inputs and pre-stored and executable iP-ATA 226 located in memory118, the computer device may present a selectable, movable, andotherwise interactive virtual body part with which a user may engage iniP-ATA.

As outlined herein, computing device 102 may include processing engine116 and memory 118, the operation and composition of which are explainedin reference to FIG. 2. First, processing engine 116 may be configuredto process one or more input signals and transmit the processed signalsto a display device 106 for presentation of a user-controllable image,such as a virtual body part, to a user 120. For purposes of the presentdescription, a user-controllable image (“UCI”) may be all or part of avirtual body part or object controllable by user input to simulatephysical movements and/or actions, wherein these physical movementsand/or actions are non-corresponding to the user's physicalmovements/actions in performing the user input. Examples of UCIsdescribed herein may include a virtual body part or virtual body parts,or virtual body parts and objects, but the scope of such examples shouldnot be limited thereto.

In an aspect, processing engine 116 may include an iP-ATA executioncomponent 202, which may process user inputs to generate display controlmessages according to instructions related to one or more iP-ATA. In anon-limiting example, a user may select a particular iP-ATA in which toengage and as a result, iP-ATA execution component 202 may load theiP-ATA instructions from iP-ATA 226 stored in memory 118. After loadingthe iP-ATA execution component 202 may generate one or more displaycontrol images and messages for transmission to a display device 106based on the iP-ATA and any inputs received from any input device.Furthermore, in an aspect, iP-ATA execution component 202 may beconfigured to alter one or more iP-ATA instances based on feedback froma user measurement device. In a non-limiting example, iP-ATA executioncomponent 202 may receive an indication that a user's neurologicalsystem is weaker or stronger than in the past and may make engaging in aparticular iP-ATA easier or more difficult to provide furtherneurological improvement.

In an additional aspect, processing engine 116 may include a virtualbody part manager 204, which may be configured to virtually constructand manage action of a virtual body part, including a virtual human bodypart, that computing device 102 may generate for simulation on a displaydevice. Furthermore, for purposes of the present description, the term“display device” may correspond to display device 106, body part device128, feedback device 130, or any other device or means capable ofproducing output corresponding to an action, and/or status of a virtualbody part, including output resulting from user input during iP-ATA.

In an aspect, virtual body part manager 204 may include a selectionmanaging component 206, which may be configured to receive one or moreselection inputs from a user or an input device manipulated by a user,wherein the selection inputs may correspond to a user selecting avirtual body part or a portion thereof. Furthermore, based on aselection input, selection manager 206 may map a select locationassociated with a selection input to a virtual body part or a portionthereof, which may correspond to a virtual body part selected forsubsequent or concurrent action by the user.

Furthermore, virtual body part manager 204 may include an action manager208, which may be configured to receive one or more action inputs from auser and generate one or more display control signals that causedisplayed action of the virtual body part. In an aspect, this displayedaction may correspond to the virtual body part or portion thereofselected by the user and mapped by selection manager 206. Additionally,action manager component 208 may generate and display the action basedon the user “dragging,” “pointing,” “tapping,” “touching,” or otherwisecorrectly manipulating at least a portion of the movable body part.

Furthermore, action manager component 208 may base its virtual body partaction generation and/or other processing actions on a particulariP-ATA, which may have been pre-selected by a user and loaded forexecution by processing engine 116. In an aspect, an action input may beinput by a user and received by computing device 102 as a result of theuser partaking in such an iP-ATA or any other pre-action therapyactivity. Additionally, in an aspect of the present disclosure, a userinput action may be physically non-corresponding to the desired oreventual action of the simulated virtual body part with which the useris interacting. For purposes of the present disclosure, anon-corresponding action may be a user action that differs relativelysignificantly from a simulated action. For example, a user engaged in apre-action therapy activity may wish to move a virtual forearm directlyupward using a mouse as an input device. To do so, according to aspectsof the disclosure, the user may first navigate a cursor and click amouse button to select the virtual forearm on a display device, therebyinputting a selection input. Next, the user may keep the cursor on thevirtual forearm and may hold a mouse button down to signal a beginningof an action input. Thereafter, the user may drag the mouse two inchesalong a mouse pad, with the mouse button held down, and may observe thevirtual forearm rise upward, for example, from a virtual hip area to avirtual head area. To carry out this action, the user's hand or forearmmay have moved approximately two inches in a direction parallel to themouse pad, but resulted in a virtual action of the virtual forearm thatwas upward in direction and appeared greater than two inches inmagnitude. Therefore, this example user input action isnon-corresponding to the action of the virtual body part.

Additionally, virtual body part manager 204 may include a demonstrativeaction manager 210, which may be configured to provide display controlmessages to a display device to make a demonstrative action of thevirtual body part. For example, demonstrative action manager 210 maystore and/or execute a retrieved demonstrative action to be displayed tothe user as a “ghost” action. In an aspect, the user may view thedemonstrative action and may then attempt to manipulate the virtual bodypart to mimic or oppose the demonstrative or ghost action.

Furthermore, virtual body part manager 204 may include a user-configuredUCI manager 212, which may tailor or otherwise configure a simulatedvirtual body part to a user's body and/or alter the behavior of thesimulated virtual body part based on one or more user characteristicvalues 222. In an aspect, such characteristics may include anatomicaland physiological data characteristic values associated with the user,such as without limitation height, weight, arm length, muscle mass,ABI/TBI-affected body parts, handedness, age, gender, eye/hair/skincolor and the like. In additional or alternative aspects, the usercharacteristics may include historical iP-ATA performance dataassociated with the user, current neurological or chemical measurementcharacteristics or parameter values, or the like.

In an aspect, user-configured UCI manager 212 may obtain these usercharacteristic values 222 from memory 118. Alternatively,user-configured UCI manager 212 may obtain these user characteristicvalues from a source external to memory 118, such as, but not limitedto, a user measurement device configured to measure neurological and/orchemical characteristics of the user during pre-action therapyactivities, by querying a user or the user's trainer, doctor, coach,therapist or rehabilitation specialist for such characteristic valuesand receiving a characteristic value input in response, or otherwisereceiving user-specific performance, anatomical, physiological, or othercharacteristic values. In another example implementation, UCI manager212 can obtain user characteristic values 222 from user measurementdevice 108 shown in FIG. 1 and discussed earlier.

In addition, user-configured UCI manager 212 may be configured tocompare the user characteristic values, or user parameters, to one ormore default parameters 224 stored in memory 118. In an aspect, defaultparameters 224 may comprise the parameters of a default virtual bodypart of the present disclosure, and may include anatomical andphysiological data (e.g., handedness, strength and bone length,limitations on range of motion, skin characteristics and the like). Suchcharacteristics may conform to the behavior and attributes of thedefault virtual body part displayed to a user before tailoring,configuring, or otherwise customizing the virtual body part to the user.In order to perform such customization, the user-configured UCI manager212 may compare the obtained user characteristic values (e.g., usercharacteristic values 222) to default parameters 224. In an aspect,where the comparing determines that a user characteristic value differsfrom the default parameter value for a characteristic, theuser-configured UCI manager may set the compared parameter of thevirtual body part to be displayed to the user's characteristic value.Alternatively, where an obtained user characteristic value does notdiffer from the default parameter, user-configured UCI manager 212 mayleave the compared parameter unchanged.

In an additional aspect, processing engine 116 may be configured togenerate and/or transmit one or more display control signals to thedisplay device to make action of the virtual body part. Furthermore,processing engine 116 may be additionally configured to calculate and/orreport an action degree or action magnitude associated with an action ofthe virtual body part. In an aspect, processing engine 116 may displaythe calculated action degree or action magnitude by generating one ormore display control messages, which may be generated and transmitted insubstantially real time, for transmission to a display device for visualindication of the action degree to the user.

Furthermore, computing device 102 may include a memory 118, which may beconfigured to store information for use by other components in a system,e.g., processing engine 116. Such information may include physicalcharacteristic values 220, which may include user characteristic values222 associated with one or more users and/or default parameters 224associated with a baseline or default UCI, such as a virtual body part.Furthermore, memory 118 may store neurological, chemical, or any otherdata related to a user's body (e.g., without limitation neurologicalsignaling data or maps, neuron activity data, etc.) generated and/orobserved by a user measurement device before, during and/or after a userengaging in pre-action therapy. Such data may also be fed back toprocessing engine 116, which may alter a current or future iP-ATA basedon the feedback.

In an additional aspect, such user data may be used to diagnose one ormore medical conditions. For example, computing device 102 may outputthe user data to a physician or other professional, who may analyze thedata and diagnose the medical condition. In an alternative or additionaland non-limiting example, computing device 102 may contain instructionsexecutable by processing engine 116 to automatically diagnose a medicalcondition based on the user data stored on memory 118.

In addition, memory 118 may include executable instructions (e.g.,executed by processing engine 116), that when performed, allow the userto engage in one or more pre-action therapy activities. As used herein,pre-action therapy activities may include interactive electronic therapyor activities, such as, but not limited to, iP-ATA 226. The iP-ATA 226may govern the behavior of a virtual body part in response to one ormore inputs by a user during pre-action therapy activities.

Additionally, executive motor functions by user 120 are involved in alliP-ATA. According to some example iP-ATA, virtual upper body parts arepresented to users to control in order to simulate purposeful physicalactions—for example, opening and closing a virtual hand. Some iP-ATA maybe virtual task therapy, which may couple engaging control of virtualbody parts and objects to accomplish tasks and/or solve problems—forexample, dropping a spoon into a cup.

Furthermore, upper extremity exercises of some non-limiting examples, aiP-ATA may include engaging control of any part or all of an affectedhand, lower or upper arm (right or left), executing flexion/extension,supination/pronation, abduction/adduction, or any other extremity orbody part action in any direction. According to the iP-ATA contemplatedherein, users can manage displays of some of, the majority of, or all ofa virtual upper extremity from substantially any angle. Additionally,the virtual body part may comprise fingers or toes, which may bemanipulated individually or in combination. The virtual body part maycomprise a wrist, which may be flexed/extended, abducted/adducted, orsupinated/pronated. Furthermore, according to some example iP-ATA, thevirtual body part may comprise an arm, wherein the lower and upper armmay be manipulated independently or in combined action of all joints ofthe arm, wrist and hand.

In some example iP-ATA where the virtual body part is a virtual hand,example therapy for pre-action therapy may include:

Pincer action to grasp a key.

Two finger action to grasp a ball and drop it into a cup.

Multi-finger action to pick up a spoon and drop it into a cup.

Full hand grasp around a mug handle.

Tapping actions by index and middle fingers on a remote controller.

Hand grasps of objects shaped as stars, circles or squares, thenplacement in similarly shaped slots.

Regarding virtual arms in some non-limiting example iP-ATA where thevirtual body part includes a virtual arm and/or a virtual hand, exampletherapy for pre-action therapy may include:

Opening a correct box, i.e., selecting and opening the correct numberedand colored box (e.g., box 24 purple) in a circle of nine numbered andcolored boxes, after observations and computations as elementary aschoosing the (single) “lowest purple box bearing an even number” (purple24 is correct) to computations based on several numbered boxes, e.g.,“choose the highest blue even numbered box, subtract the second of itsnumbers from the first, square it and find the green box with thatresult” (if 92 blue is selected the subtraction yields number 7, whichwhen squared is 49, so green box 49 is correct). Nine box open action,as above, with voice instructions to the user.

Similar open the box action in a more elementary vertical presentationof five boxes.

Light bulb action requiring the user to unscrew a light bulb, choose thecorrect lettered socket and screw the bulb into the correct socket.

Engaging card therapy, for example in a simple action the virtual armand hand are controlled to select a pair of deuces, place that pair,right side up on a surface, then the user must choose the lowestnumbered pair that wins over a pair of deuces, alternately the highestnumbered pair that wins over deuces, then the lowest (or highest) pairof picture cards that wins over deuces and so forth, to more complexcombinations of engaging cards/hands.

Puzzle therapy in which the cursor is used to move some number of puzzlepieces to assemble a complete representation of any display noted above.For example, a hand image, in any orientation, position andconfiguration may be disassembled by the puzzle action into puzzlepieces to be reassembled by the user, or a more complex disassembly ofthe nine box arm action may be “puzzled.”

Simple number action displaying 0-9 and processes (add, subtract,multiply, divide and equals sign) and calling for the iP-ATA user to usea virtual arm and hand to select numbers and processes and to make anynumber of computations by arraying the numbers and processes accurately.

Simple letter action engaging any or all letters of the alphabet andcalling for the iP-ATA user to use a virtual arm and hand to selectletters to make any number of words by arraying the letters accurately.

Where the virtual body part is at least one virtual muscle, pre-actiontherapy may include selection of said at least one virtual muscle tocause it to contract or relax at any rate of speed or to stop, forexample, to end cramping or focal cervical dystonia or to regainmovement impeded by hand dystonia. Therefore by loading and/or executingthe one or more stored iP-ATA 226 of memory 118, computing device 102may present a user with a UCI, such as a virtual body part, with whichthe user may interact to participate in pre-action therapy activities.

In a further aspect, computing device 102 may include a body part deviceinterface component 228, which may be configured to interface with anexternal (or integral) body part device (e.g., body part device 128(FIG. 1)), generate one or more control signals based on the usercontrol of the virtual body part, or UCI, and transmit the one or morecontrol signals to the body part device 128 for eventual stimulation ofa target body part 150. In some examples, body part device interfacecomponent 228 may include a body part device computing manager 230 whichmay generate the one or more control signals based on the user controlof the virtual body part. In a further aspect, body part devicecomputing manager 230 may include a transmitter 232, which may becommunicatively coupled to body part device 128 via a communicativeconnection, and may be configured to transmit the one or more controlsignals to body part device 128. In some examples, transmitter 232 maytransmit the signals wirelessly or via a transmission medium, dependingon whether computing device 102 is tethered to body part device 128 viaa transmission medium, such as a bus or other wire. For example, wherecomputing device 102 is connected to body part device 128, transmitter232 may be configured to transmit the control signals over thetransmission medium (though it may also transmit the control signalswirelessly as well). Alternatively, where the computing device 102 isnot tethered to the body part device, transmitter 232 may transmit theone or more control signals wirelessly. As such, transmitter 232 mayinclude one or more antennas or transceivers.

FIG. 3 illustrates an example input device 104 for recognizing one ormore physical or neurological signals of a user, processing saidsignals, and transmitting a related signal to a computer device as aninput. Besides standard mouse-like devices, in some examples, inputdevice 104 may include a brain-computer interface (“BCI”), mind-machineinterface (“MMI”), direct neural interface, or a brain-machine interface(“BMI”), or any other interface, neurological signal detection device,or component known to one of ordinary skill in the art capable ofproviding input to a computer device based on neurological signaling. Insome examples, neurological signals may be received or detected from auser's brain, a user's spinal cord, or any other neurological pathway inthe user's body, e.g., with user measurement device 108 (FIG. 1).Furthermore, input device 104 may include a headset or other externaldevice that is configured to be affixed to a user's body, such as to theuser's head, torso, back, arm, hand, foot, knee, leg, foot, toe, finger,such that neurological signals may be received by one or more sensorsattached to the external device.

Additionally, in an aspect, input device 104 may include a user actionrecognizing component 124. In some examples, user action recognizingcomponent 124 may include a neurological signal recognizing component302, which may be configured to recognize or detect, for example,invasively or non-invasively neurological signals that may be used tocontrol a virtual image and/or a related body part device to move basedon the neurological signals. For example, neurological signalrecognizing component 302 may comprise one or more neurological signalsensors, such as neural sensors or other brain-wave sensors known to oneof ordinary skill in the art. In an aspect, these sensors may be affixeddirectly to the user or a body part thereof, such as the brain, thespinal cord, or the like, or may be located proximately close to theuser or the body part (e.g., above the skin or hair), such that thesensors may recognize or sense the neurological signal by non-invasivemeans.

Furthermore, input device 104 may include a neurological signalprocessing component 304, which may be configured to process arecognized or detected neurological signal, including signal filteringand noise reduction. For example, in an aspect, the neurological signalprocessing component 304 may be configured to correlate neurologicalsignal to movement of one or more virtual images, virtual body parts,cursors, or other displayed objects being observed by the user. Forexample, in a non-limiting example, where a virtual hand is observed bythe user on a display, the user may attempt to select a portion of thevirtual hand, such as a finger, and move the finger in a flexor (orother) motion. This attempt to select and/or move the portion of thevirtual hand may cause the user's brain and associated neurologicalcircuitry to produce neurological signals corresponding to signals thatwould move a corresponding portion of the user's hand, which, in someaspects, may no longer be present on the user's body. However, theneural pathways associated with such hand movement may still be presentin the user's brain and body. The neurological signal processingcomponent may process these neurological signals to correlate to anassociated virtual movement of the virtual image being simulated.Alternatively, the neurological signal may be non-corresponding toactual movement of the no-longer-present body part but may instead berelated to neural selection of a displayed cursor. For example, the usermay envision the cursor in the user's brain and use mental processes tomove the cursor to a virtual body part, select the body part through amental selection process, and move the body part (e.g., a flexormovement of a displayed virtual finger).

Such processing by neurological signal processing component 304 maycomprise executing, via one or more processors, one or more instructionsstored on a computer-readable medium. In an aspect, neurological signals(e.g., those recognized by user action recognizing component 124 orneurological signal recognizing component 302) may be correlated to oneor more control signals for altering the virtual image (e.g., selection,movement, etc.) by means of a formula, algorithm or flow of mathematicaloperations, look-up table, or other stored correlation information.

In a further aspect, to allow sufficient signal strength to interfacewith a computer device (e.g., computing device 102 (FIG. 1)), inputdevice 104 may include a signal amplifying component 306, which may beconfigured to amplify the voltage of neurological signals (e.g.,electrical signals measured with or output from an EEG device) to levelsthat may be input to the computer device as user input signals. In anaspect, signal amplifying component 306 may comprise one or more digitalor analog amplifiers known to those of ordinary skill in the art.Furthermore, input device 104 may include a user input signaltransmitting component 308, which may be configured to transmit theprocessed and amplified neurological signals, or user input signals, toone or more computer devices to effectuate virtual or non-virtualmovement of a virtual or non-virtual body part. In some examples, userinput signal transmitting component 308 may include a wired or wirelesstransmitter or transceiver and may include one or more transmissionantennae and related circuitry.

Turning to FIG. 4, a flow diagram illustrating a method of physical,pre-action and related neural therapy according to an embodiment of thepresent disclosure is shown. In step S1, system 100 (FIG. 1) can detectan input from a user for controlling a simulated human anatomicalmovement. The input detected in step S1 can be in the form of an action,movement, or other type of input distinct from physical aspects of theanatomical movement to be performed or modeled. Further, the inputdetected in step S1 can include an input from input device 104 (FIG. 1)or user measurement device 108 (FIG. 1), and thus may include detectinga neuronal activity of the user (e.g., by way of an EEG device). Step S1can also include input device 104 detecting the occurrence of auser-transmitted brain signal (e.g., a measured electrical signal), andthen providing an input to computing device 102 based on the occurrenceof the user-transmitted brain signal. In an example aspect, detecting auser-transmitted brain signal in step S1 with input device 104 may notinclude translating the user-transmitted brain signal into acorresponding input, but rather using the detecting event itself as aninput from input device 104 to computing device 102. In step S2, system100 (FIG. 1) can, e.g., through computing device 102, model thesimulated anatomical movement. In addition or alternatively, computingdevice 102 can model the simulated anatomical movement with body partdevice 128 in step S2 simultaneously with the modeling of the humananatomical movement with a virtual body part.

In step S3, system 100 (FIG. 1) (e.g., through processing engine 116(FIG. 1) of computing device 102 (FIG. 1)) can compare the simulatedhuman anatomical movement from the user with a model human anatomicalmovement. In the event that the simulated anatomical movement does notmatch the model human anatomical movement, system 100 (e.g., throughprocessing engine 116 of computing device 102) can determine the extentto which the simulated anatomical movement differs from the modelanatomical movement in step S4. In step S5, system 100 (e.g., throughfeedback device 130)) can provide either positive or negative sensoryfeedback to the user based on the extent of the difference determined instep S4. The degrees to which feedback can vary are discussed elsewhereherein in the discussion regarding FIG. 1 and feedback device 130, andmay include increasing or decreasing the amount of haptic or otherfeedforward or feedback based on an accuracy of the simulated anatomicalmovement, forcibly actuating an extremity of the user, etc. In the eventthat the simulated anatomical movement matches the model anatomicalmovement, system 100 can provide sensory feedback to the user indicatingthat the user provided a correct input controlled movement to system100. Following the feedback to the user, methods according to anembodiment of the present disclosure can return to step S1 to detectanother user input, thereby allowing the methods disclosed herein to berepeated as desired. Although steps S2-S6 are presented in alternativesequential order in FIG. 4, it is understood that the execution of somesteps may occur in rapid succession or even simultaneously.Specifically, the calculation of the performance metric S7 (see below)can occur at the same time as feedback is provided to the user in stepsS5 or S6.

As system 100 (FIG. 1) provides sensory feedback to the user in step S5or step S6, system 100 can simultaneously monitor the brain activity ofthe user with a neural monitoring device, e.g., through user measurementdevice 108 (FIG. 1). To monitor a user as feedback is provided in stepsS5 or S6, user measurement device 108 can include an EEG device orsimilar instrument, e.g., a PET scanner, an fMRI scanner and/or an MVPAscanner.

System 100 (FIG. 1), e.g., through processing engine 116 (FIG. 1) ofcomputing device 102 (FIG. 1), can also calculate a performance metricbased on the comparison between the simulated anatomical movement andthe model anatomical movement in step S7. In an example embodiment,computing device 102 can compute the user's percentage accuracy ofimitating or opposing the model anatomical movement with one or moreprevious inputs, and display this metric on display device 106 (FIG. 1).

Embodiments of system 100 (FIG. 1) which include restraint therapydevice 152 (FIG. 1) can also include step S8 of providing restrainttherapy to one or more extremities of the user. In particular, restrainttherapy device 152 of system 100 can restrain a user's extremity where auser desires to exercise or not exercise particular body parts whenproviding the user input detected in step S1. Methods according to thepresent disclosure can include alternatively restraint therapy andun-restraint therapy of a user extremity (e.g., by executing orbypassing step S8 in sequence cycles through the method) to customizethe user's pre-action therapy.

FIG. 5 is a block diagram example illustrating a machine in the form ofa computer system 500, within which a set or sequence of instructionsfor causing the machine to perform any one of the methodologiesdiscussed herein may be executed, according to an example embodiment. Inalternative embodiments, the machine operates as a standalone device ormay be connected (e.g., networked) to other machines. In a networkeddeployment, the machine may operate in the capacity of either a serveror a client machine in server-client network environments, or it may actas a peer machine in peer-to-peer (or distributed) network environments.The machine may be a personal computer (“PC”), a tablet PC, a set-topbox (“STB”), a Personal Digital Assistant (“PDA”), a mobile telephone, aweb appliance, a network router, switch or bridge, a cloud-basedcomputing device, or any machine capable of executing instructions(sequential or otherwise) that specify actions to be taken by thatmachine. In an embodiment, computer system 500 can include a digitalcomputing device such as computing device 102 (FIG. 1). Further, whileonly a single machine is illustrated, the term “machine” shall also betaken to include any collection of machines that individually or jointlyexecute a set (or multiple sets) of instructions to perform any one ormore of the methodologies discussed in the present disclosure.

Example computer system 500 can include at least one processor 502(e.g., a central processing unit (“CPU”), a graphics processing unit(“GPU”), digital signal processor (“DSP”), custom processor—any or all,processor cores, compute nodes, etc.), a main memory 504 and a staticmemory 505. Components of computer system 500 communicate with eachother via a link 508 (e.g., bus). Computer system 500 may furtherinclude a video display unit 510, an alphanumeric input device 512(e.g., a keyboard), and a user interface (“UI”) navigation device 514(e.g., a mouse). In one embodiment, video display unit 510, input device512 and UI navigation device 514 are incorporated into a touch screendisplay. Computer system 500 may additionally include a storage device515 (e.g., a drive unit), a signal generation device 518 (e.g., aspeaker), a network interface device 520, and one or more sensors (notshown), such as a global positioning system (“GPS”) sensor, compass,accelerometer, or other sensor.

Computer system 500 may be configured to interface with one or moreexternal devices, such as an input device (e.g., input device 104 (FIG.1), user measurement device 108 (FIG. 1)), an output device (e.g.,display device 106 (FIG. 1), feedback device 130 (FIG. 1), body partdevice 128 (FIG. 1, or a combination input/output device (e.g., userinterface device 160 (FIG. 1)). Specifically, computer system 500 maycontain circuitry and/or instructions that allow computer system 500 toconnect to and/or communicate with these sub-component or externaldevices.

Storage device 515 can include a machine-readable medium 522 on which isstored one or more sets of data structures and instructions 524 (e.g.,software) embodying or used by any one or more of the methodologies orfunctions described herein. Instructions 524 may also reside, completelyor at least partially, within the main memory 504, static memory 505and/or within the processor 502 during execution thereof by the computersystem 500, with the main memory 504, static memory 506 and theprocessor 502 constituting machine-readable media.

While the machine-readable medium 522 is illustrated in an exampleembodiment to be a single medium, the term “machine-readable medium” mayinclude a single medium or multiple media (e.g., a centralized ordistributed database, and/or associated caches and servers) that storethe one or more instructions 524. The term “machine-readable medium” caninclude any tangible medium that is capable of storing, encoding orcarrying instructions for execution by the machine and that cause themachine to perform any one or more of the methodologies of the presentdisclosure or that is capable of storing, encoding or carrying datastructures used by or associated with such instructions. The term“machine-readable medium” shall accordingly be taken to include, but notbe limited to, solid-state memories and optical and magnetic media.Specific examples of machine-readable media include non-volatile memory,including, by way of example, semiconductor memory devices (e.g.,Electrically Programmable Read-Only Memory (“EPROM”), ElectricallyErasable Programmable Read-Only Memory (“EEPROM”)) and flash memorydevices; solid state drives (“SSDs”), magnetic disks such as internalhard disks and removable disks; magneto-optical disks; and ROM discssuch as CD-ROM, DVD-ROM and Blu-Ray™ discs.

Instructions 524 may further be transmitted or received over acommunications network 526 using a transmission medium via the networkinterface device 520 using any of a number of well-known transferprotocols (e.g., HTTP, XML, FTP). Examples of communication networksinclude a local area network (“LAN”), a wide area network (“WAN”), theInternet, mobile telephone networks, Plain Old Telephone (“POTS”)networks and wireless data networks (e.g., Wi-Fi, 3G and 4G LTE/LTE-A orWiMAX networks) or any combination thereof. The term “transmissionmedium” can include any intangible medium that is capable of storing,encoding, or carrying instructions for execution by the machine andincludes digital or analog communications signals or other intangiblemedium to facilitate communication of such software.

Examples, as described herein, may include, or may operate on, logic ora number of modules, or mechanisms. Modules are tangible entitiescapable of performing specified operations and may be configured orarranged in a certain manner. In an example, circuits may be arranged(e.g., internally or with respect to external entities such as othercircuits) in a specified manner as a module. In an example, the whole orpart of one or more computer systems (e.g., a standalone, client orserver computer system) or one or more hardware processors may beconfigured by firmware or software (e.g., instructions, an applicationportion, or an application) as a module that operates to performspecified operations. In an example, the software may reside on anon-transitory machine-readable medium or in a transmission signal. Inan example, the software, when executed by the underlying hardware ofthe module, causes the hardware to perform the specified operations.

Accordingly, the terms “module” and “device” are understood to encompassa tangible entity, be that an entity that is physically constructed,specifically configured (e.g., hardwired), or temporarily (e.g.,transitory) configured (e.g., programmed) to operate in a specifiedmanner or to perform part or all of any operation described herein. Forexample, where the modules comprise a general-purpose hardware processorconfigured using software; the general-purpose hardware processor may beconfigured as respective different modules at different times and/ordifferent spaces. Accordingly, software may configure a hardwareprocessor, for example, to constitute a particular module at oneinstance of time and to constitute a different module at a differentinstance of time.

As used in this disclosure, the terms “component,” “module,” “system”and the like are intended to include a computer-related entity, such asbut not limited to hardware, firmware, a combination of hardware andsoftware, software, or software in execution. For example, a componentmay be, but is not limited to being, a process running on a processor, aprocessor, an object, an executable, a thread of execution, a programand/or a computer. By way of illustration, both an application runningon a computing device and the computing device can be a component. Oneor more components can reside within a process and/or thread ofexecution and a component may be localized on one computer and/ordistributed between two or more computers. In addition, these componentscan execute from various computer readable media having various datastructures stored thereon. The components may communicate by way oflocal and/or remote processes such as in accordance with a signal havingone or more data packets, such as data from one component interactingwith another component in a local system, distributed system and/oracross a network such as the Internet with other systems by way of thesignal.

Moreover, the term “or” is intended to mean an inclusive “or” ratherthan an exclusive “or.” That is, unless specified otherwise, or clearfrom the context, the phrase “X employs A or B” is intended to mean anyof the natural inclusive permutations. That is, the phrase “X employs Aor B” is satisfied by any of the following instances: X employs A; Xemploys B; or X employs both A and B. or clear from the context to bedirected to a singular form.

Various aspects or features will be presented in terms of systems thatmay include a number of devices, components, modules and the like. It isto be understood and appreciated that the various systems may includeadditional devices, components, modules, etc. and/or may not include allof the devices, components, modules etc. discussed in connection withthe figures. A combination of these approaches may also be used.

The various illustrative logics, logical blocks, modules and circuitsdescribed in connection with the embodiments disclosed herein may beimplemented or performed with a general purpose processor, a digitalsignal processor (“DSP”), an application specific integrated circuit(“ASIC”), a field programmable gate array (“FPGA”) or other programmablelogic device, discrete gate or transistor logic, discrete hardwarecomponents, or any combination thereof designed to perform the processesdescribed herein. A general-purpose processor may be a microprocessor,but, in the alternative, the processor may be any conventionalprocessor, controller, microcontroller, or state machine. A processormay also be implemented as a combination of computing devices, e.g., acombination of a DSP and a microprocessor, a plurality ofmicroprocessors, one or more microprocessors in conjunction with a DSPcore, or any other such configuration. Additionally, at least oneprocessor may comprise one or more modules operable to perform one ormore of the steps and/or actions described above.

Further, the steps and/or actions of a method or algorithm described inconnection with the aspects disclosed herein may be embodied directly inhardware, in a software module executed by a processor, or in acombination of the two. A software module may reside in RAM memory,flash memory, ROM memory, EPROM memory, EEPROM memory, registers, a harddisk, a removable disk, a CD-ROM, or any other form of storage mediumknown in the art. An exemplary storage medium may be coupled to theprocessor, such that the processor can read information from and writeinformation to, the storage medium. In the alternative, the storagemedium may be integral to the processor. Further, in some aspects, theprocessor and the storage medium may reside in an ASIC. Additionally,the ASIC may reside in a user terminal. In the alternative, theprocessor and the storage medium may reside as discrete components in auser terminal. Additionally, in some aspects, the steps and/or actionsof a method or algorithm may reside as one or any combination or set ofcodes and/or instructions on a machine readable medium and/or computerreadable medium, which may be incorporated into a computer programproduct.

In one or more aspects, the processes described may be implemented inhardware, software, firmware, or any combination thereof. If implementedin software, the processes may be stored or transmitted as one or moreinstructions or code on a computer-readable medium. Computer-readablemedia includes both computer storage media and communication mediaincluding any medium that facilitates transfer of a computer programfrom one place to another. A storage medium may be any available mediathat can be accessed by a computer. By way of example and notlimitation, such computer-readable media can comprise RAM, ROM, EEPROM,CD/DVD-ROM or -RW or other optical disk storage, magnetic disk storageor other magnetic storage devices, or any other medium that can be usedto carry or store desired program code in the form of instructions ordata structures and that can be accessed by a computer. Also, anyconnection may be termed a computer-readable medium. For example, ifsoftware is transmitted from a website, server, or other remote sourceusing a coaxial cable, fiber optic cable, twisted pair, digitalsubscriber line (“DSL”), or wireless technologies such as infrared,radio and microwave, then the coaxial cable, fiber optic cable, twistedpair, DSL, or wireless technologies such as infrared, radio andmicrowave are included in the definition of medium. Disk and disc, asused herein, includes magnetic hard-drive (“HD”), solid state drive(“SSD”), compact disc (“CD”), laser disc, optical disc, digitalversatile disc (“DVD”), floppy disk and Blu-ray disc where disks usuallyreproduce data magnetically, while discs usually reproduce dataoptically with lasers. Combinations of the above should also be includedwithin the scope of computer-readable media.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a,” “an,” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising,” when used in this specification, specify thepresence of stated features, integers, steps, operations, elementsand/or components, but do not preclude the presence or addition of oneor more other features, integers, steps, operations, elements,components and/or groups thereof.

The corresponding structures, materials, acts and equivalents of allmeans or step plus function elements in the claims below are intended toinclude any structure, material, or act for performing the function incombination with other claimed elements as specifically claimed. Thedescription of the present invention has been presented for purposes ofillustration and description but is not intended to be exhaustive orlimited to the invention in the form disclosed. Many modifications andvariations will be apparent to those of ordinary skill in the artwithout departing from the scope and spirit of the invention. Theembodiment was chosen and described in order to best explain theprinciples of the invention and the practical application and to enableothers of ordinary skill in the art to understand the invention forvarious embodiments with various modifications as are suited to theparticular use contemplated.

We claim:
 1. An apparatus for physical, pre-action, extremity andrelated spinal cord, brain stem and neural therapies, the apparatuscomprising: a computing device configured to convert an input controlaction into a simulation instruction, wherein the input control actionis provided by an input device; at least one simulated extremityoperatively connected to the computing device and configured to simulatethe at least one modeled human anatomical movement based on thesimulation instruction derived from the input control action, whereinthe at least one modeled human anatomical movement is distinct from theinput control action, and wherein the at least one simulated extremitycomprises a robotic anatomical model configured to simulate one the atleast one human anatomical movement; and a feedback device operativelyconnected to the computing device and configured to transmit a sensoryresponse, wherein the sensory response is based on the modeled humananatomical movement.
 2. The apparatus of claim 1, wherein the feedbackdevice is coupled to a user extremity, and wherein the sensory responseacts on the user extremity to stimulate one or more of the user'sphysical body parts.
 3. The apparatus of claim 1, further comprising arestraint therapy device in communication with the feedback device andconfigured to restrain at least one extremity of a user, wherein thefeedback device is further configured to control the restraint therapydevice to restrain or assist at least one extremity of a user.
 4. Theapparatus of claim 1, wherein the input device includes at least one ofa controller, a motion control system, a sensory body harness and anelectroencephalography (“EEG”) device.
 5. The apparatus of claim 4,wherein the input device includes the EEG device, and the EEG deviceincludes at least one of a PET scanner, an fMRI scanner and an MVPAscanner.
 6. The apparatus of claim 1, wherein the feedback devicecomprises a haptic feedback unit operatively connected to the computingdevice and configured to transmit the sensory response to a user.
 7. Amethod for physical, pre-action, extremity and related spinal cord,brain stem and neural therapies, the method comprising: translating aninput control action into a simulation instruction for at least onemodeled human anatomical movement, wherein the at least one modeledhuman anatomical movement is distinct from the input control action;simulating, with at least one simulated extremity, the at least onemodeled human anatomical movement based on the simulation instruction;calculating a difference between an ideal movement and the at least onemodeled anatomical movement; and transmitting a sensory response to auser, wherein the sensory response is derived from the calculateddifference.
 8. The method of claim 7, further comprising: translating acooperative or competing input control action into a simulationinstruction for at least one cooperative or competing human anatomicalmovement; and simulating, with the at least one model extremity, the atleast one cooperative or competing human anatomical movement based onthe simulation instruction for the at least one cooperative or competinghuman anatomical movement.
 9. The method of claim 7, further comprisingrestraining or assisting at least one extremity of the user.
 10. Themethod of claim 7, further comprising modifying the sensory response toexcite neurons in at least one of a prefrontal cortex, a premotor cortexand a supplementary motor area of the user.
 11. The method of claim 7,further comprising monitoring a neuronal activity of the user, andconverting the monitored neuronal activity into the input controlaction.
 12. The method of claim 7, wherein the at least one modeledhuman anatomical movement consists of movements other than the at leastone modeled human anatomical movement.
 13. The method of claim 7,wherein the at least one model extremity includes at least one of avirtual model and a robotic model.
 14. The method of claim 7, furthercomprising diagnosing a medical condition of the user based on thecalculated difference between the ideal movement and the at least onemodeled anatomical movement.
 15. A system for physical, pre-action,extremity and related spinal cord, brain stem and neural therapies, thesystem comprising: an input device configured to receive an inputcontrol action from a user; at least one simulated extremity operativelyconnected to the input device and configured to simulate at least onemodeled human anatomical movement based on the input control action; afeedback device operatively connected to the input device and configuredto transmit a sensory response to the user; and a computing deviceoperatively connected to the input device, the at least one simulatedextremity and the feedback device, wherein the computing device isconfigured to perform actions including: simulate, with the at least onesimulated extremity, the at least one modeled human anatomical movementbased on the input control action, wherein the at least one modeledhuman anatomical movement is distinct from the input control action,calculate a difference between an ideal movement and the modeled humananatomical movement, and transmit a sensory response via the feedbackdevice to a user, wherein the sensory response is derived from thecalculated difference.
 16. The system of claim 15, wherein the at leastone simulated extremity comprises one of a robotic extremity and avirtual extremity for simulating the model human anatomical movement invirtual space, the virtual extremity being displayed upon a displaydevice.
 17. The system of claim 15, further comprising a restrainttherapy device operatively connected to the computing device, whereinthe computing device is further configured to instruct the restrainttherapy device to restrain or assist at least one extremity of the user.18. The system of claim 15, wherein the feedback device comprises hapticfeedback units mechanically coupled to the feedback device andconfigured to provide the sensory response to the user.
 19. The systemof claim 15, wherein the input device includes at least one of acontroller, a motion control system, a sensory body harness and anelectroencephalography device.
 20. The system of claim 15, wherein thecomputing device is further configured to receive at least onecooperative or competing input control action from at least onecooperative or competing user, translate the at least one cooperative orcompeting input control action into at least one cooperative orcompeting simulated human anatomical movement, and simulate the at leastone cooperative or competing simulated human anatomical movement withthe model extremity based on the at least one cooperative or competinginput control action.